title: A multi-center retrospective analysis of treatment effects and quality of life in adult patients with cranial ependymomas.
abstract: Long term quality of life data of adult patients harboring intracranial ependymomas have not been reported. The role of adjuvant radiation therapy in Grade II ependymomas is unclear and differs from study to study. We therefore sought to retrospectively analyze outcome and quality of life of adult patients that were operated on intracranial ependymomas at four different surgical centers in two countries. All patients were attempted to be contacted via telephone to assess quality of life (QoL) at the time of the telephone interview. The standard EORTC QoL Questionnaire C30 (EORTC QLQ-C30) and the EORTC QLQ-Brain Cancer Module (QLQ-BN20) were used. 64 adult patients with intracranial ependymomas were included in the study. The only factor that was associated with increased survival was age <55 years (p < 0.001). Supratentorial location was correlated with shorter progression free survival than infratentorial location (PFS; p = 0.048). In WHO Grade II tumors local irradiation did not lead to increased PFS (p = 0.888) or overall survival (p = 0.801). Even for incompletely resected Grade II tumors local irradiation did not lead to a benefit in PFS (p = 0.911). In a multivariate analysis of QoL, irradiated patients had significantly worse scores in the item "fatigue" (p = 0.037) than non-irradiated patients. Here we present QoL data of adult patients with intracranial ependymomas. Our data show that local radiation therapy may have long-term effects on patients' QoL. Since in the incompletely resected Grade II tumors local irradiation did not lead to a benefit in PFS in this retrospective study, prospective randomized studies are necessary. In addition to age, supratentorial tumor location is associated with a worse prognosis in adult ependymoma patients.
authors.affiliation: Department of Neurosurgery, University Hospital Frankfurt, Johann Wolfgang Goethe University, Schleusenweg 2-18, 60528, Frankfurt, Germany. stephan.duetzmann@gmail.com
authors.forename: Stephan
authors.initials: S
authors.lastname: Dützmann
authors.forename: Bawarjan
authors.initials: B
authors.lastname: Schatlo
authors.forename: Alexander
authors.initials: A
authors.lastname: Lobrinus
authors.forename: Michael
authors.initials: M
authors.lastname: Murek
authors.forename: Maria
authors.initials: M
authors.lastname: Wostrack
authors.forename: Carolin
authors.initials: C
authors.lastname: Weiss
authors.forename: Karl
authors.initials: K
authors.lastname: Schaller
authors.forename: Andreas
authors.initials: A
authors.lastname: Raabe
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meyer
authors.forename: Roland
authors.initials: R
authors.lastname: Goldbrunner
authors.forename: Kea
authors.initials: K
authors.lastname: Franz
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.forename: Christian
authors.initials: C
authors.lastname: Senft
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D004806:Ependymoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult